Quote of the Month
“Aging is not lost youth but a new stage of opportunity and strength.” – Betty Friedan
Medicare Coverage of Advance Care Planning
Beginning in 2016, the Centers for Medicare & Medicaid Services (CMS) will pay for advance care planning (ACP) services provided to Medicare beneficiaries by physicians or other health care professionals. The services can also be provided through a team approach by both physicians and other staff. ACP is a voluntary option for Medicare beneficiaries that includes conversations between patients and their practitioners, “both before an illness progresses and during the course of treatment.” These discussions may include a review of options for end-of-life care, under what circumstances, if any, the individual may want to be kept alive if unable to express their wishes, and education about tools such as advance directives. The Medicare statute currently provides coverage for ACP under the “Welcome to Medicare” visit but this may not be at a time the consumer wants or has a need to talk about these issues so CMS is creating separate payment codes for ACP to allow practitioners to have these conversations with beneficiaries at the most appropriate time based on patient need. It is important to note that when a beneficiary chooses to receive ACP services, Part B cost sharing will apply as it does for other physicians’ services unless ACP is provided as part of Medicare’s Annual Wellness Visit.
NCOA has a fact sheet that describes what advance care planning is, and how it differs from advance directives and hospice care. The American Bar Association’s Bifocal has an article summarizing CMS’ ACP rule.
RAISE Family Caregivers Act
Yesterday, the U.S. Senate unanimously passed the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1719)introduced by Senator Collins. “This bill directs the Department of Health and Human Services (HHS) to develop, maintain, and periodically update a National Family Caregiving Strategy. HHS shall convene a Family Caregiving Advisory Council to advise it on recognizing and supporting family caregivers.” The bill was amended to remove a section related to the sharing of data among federal agencies and shorten the sunset date of the Act from December 31, 2030 to December 31, 2025. The bill was sent to the House today for “floor consideration.”
Committee on Health, Education, Labor and Pensions (HELP) Ranking Member Patty Murray said, “By launching a National Family Caregiving strategy and advisory council, the RAISE Family Caregivers Act would help us better understand and meet the needs of numerous people across the country who are making an enormous contribution to their families and to our health care system – and who, too often, are overlooked.”
According to AARP’s Public Policy Institute, about 40 million family caregivers in the United States provided approximately 37 billion hours of care to adults in 2013, with an estimated economic value of about $470 billion in 2013, up from approximately $450 billion in 2009.
Thank your U.S. Senators for their vote and contact your member in the House to ask for support in passing the RAISE Act!
PA Community HealthChoices Update
Pennsylvania continues to move forward with its Managed Long Term Services and Supports (MLTSS) proposal, now called Community HealthChoices (CHC). (Please see CARIE Connection archives for more background information.) DHS released the draft CHC RFP and draft program requirements for public comment on November 16, 2015. Comments are due on December 11. All CHC related drafts and other information may be found on the CHC webpage. At a joint PA House Health and Aging & Adult Services Committee meeting on November 23, OLTL Deputy Secretary Burnett stated that DHS plans to release additional information and draft materials for public comment on December 14 related to the enrollment/eligibility process, quality, and protection & rights. These comments will be due January 8. Once DHS has reviewed the comments, it plans to officially release the RFP giving Managed Care Organizations (MCOs) 60 days to respond.
DHS announced that it decided to pursue concurrent 1915(b) and 1915(c) waivers to implement CHC. A 1915(b) waiver allows DHS to implement mandatory managed care, while a 1915(c) waiver addresses eligibility and providing LTSS in home and community-based settings. There are five 1915(c) waivers, including the Aging Waiver, that Pennsylvania plans to combine into one 1915(c) waiver for CHC and DHS will also develop a 1915(b) waiver.
CARIE is working with other advocates throughout the state to raise concerns about Pennsylvania’s aggressive plan to implement CHC. PENNLIVE posted an op-ed submitted by Community Legal Services of Philadelphia, PA Health Law Project, Disability Rights Network of PA, PA Health Access Network, and CARIE.
CARIE also updated its CHC consumer flyer to reflect information released by DHS. The changes include adding the new name Community HealthChoices, identifying the exclusion of LIFE participants from the plan, and updating DHS’ new website address. Please continue to help us educate consumers and their caregivers throughout Pennsylvania by distributing this flyer.
Webinars and Videos
Justice in Aging is conducting a webinar, Assisted Living: State Strategies for Meeting
Residents’ Health Care Needs, on Thursday, December 17 at 11:00 a.m. PT/2:00 p.m. ET. Click here to register.
Here is a two minute animated video, Falls in Older Adults.
Just the Links
NCOA has posted a chart that shows the Medicare premiums and cost-sharing amounts for 2016.
The Kaiser Family Foundation released an issue brief, What’s in Store for Medicare’s Part B Premiums and Deductible in 2016, and Why? that explains the premium increase, the hold harmless provision, and a $3 repayment surcharge to cover the cost of the reduced premium rate in 2016.
U.S. News and World Reports posted an article, How Retirement Benefits Will Change in 2016.
The Consumer Financial Protection Bureau has a new Planning for Retirement tool to help decide when to claim your Social Security benefits. For more retirement and pension benefits questions, visitUSA.gov.
The 2016 SSI and spousal impoverishment standards have been released.
The CMS Program Statistics website replaces the former Medicare and Medicaid Statistical Supplement. “The website will include over 100 detailed, easy-to-access data tables on national health care, Medicare populations, utilization, and expenditures, as well as counts for Medicare-certified institutional and non-institutional providers.” Users can search for Medicare data through a new interactive Medicare Enrollment Dashboard and can narrow the search by geographical areas, including national, state/territory, and county.
Due to the Supreme Court’s Obergefell decision, CMS issued guidance to state Medicaid Directors in this letter requiring states to apply Medicaid law and regulations, such as spousal impoverishment rules, for spouses in same-sex marriages in the same way as applied to opposite-sex marriages.
The Kaiser Family Foundation posted Medicaid Home and Community-Based Services Programs: 2012 Data Update.
The SCAN Foundation, in collaboration with AARP and LeadingAge, funded economic and actuarial long-term services and supports (LTSS) policy modeling. Several reports were written by different financing organizations as a result. Various resources are available including a video about the impact of high costs for consumers and caregivers. “The potentially catastrophic consequences of becoming disabled and needing long-term care is arguably the gravest financial risk that older adults face,” said the authors of the Urban Institute’s research report, Microsimulation Analysis of Financing Options for Long-Term Services and Supports.
Money Magazine posted a series of articles about the costs of dementia throughout three stages – early, middle, and late.
Dr. Mark Lachs, and Dr. Karl Pillemer published an article in The New England Journal of Medicine summarizing recent research and issues related to elder abuse.
The Bipartisan Policy Center’s Health and Housing Expert Forum posted a series of articles on falls prevention.
Four articles about person-centered care were published in the recent edition of the Journal of the American Geriatrics Society.
The Institute for Research on Poverty released four policy briefs about current research on the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, including: The Basics of SNAP Food Assistance, SNAP Trends and Antipoverty Impacts, SNAP, Food Security, and Health, and SNAP and the Low-Income Safety Net.
Needhelppayingbills has information on thousands of non-profit agencies, government and public assistance programs. (Just be cautious of the ads.)
The Congressional Research Service released report, Researching Current Federal Legislation and Regulations: A Guide to Resources for Congressional Staff.
Just for Fun
Tour the world with Google’s Cultural Institute and Food52’s “Cookies of the World.” According to Google’s blog, you can now virtually “step on stage” with the Google Cultural Institute. The website now features world’s leading performing arts venues such as Carnegie Hall and the Bolshoi Theatre. “In a new virtual exhibition from the Google Cultural Institute and more than 60 performing arts organizations, you can experience dance, drama, music and opera alongside some of the world’s leading performers – onstage, backstage and with a 360 degree-view of the action.”
Food52’s cookie map features 46 cookie recipes and related stories from throughout the globe. Find an old family favorite or try something new this holiday season.
CARIE wants to extend our heartfelt thanks to all of our volunteers and supporters in helping us have another productive year serving older adults. With the state at a stalemate in passing a budget and hurting our bottom line, we appreciate your end-of-year donations more than ever. Best wishes to all for a happy, joyful, and peaceful holiday season!
On November 9, CARIE submitted comments on proposed nondiscrimination in health programs and activities regulations to the Department of Health and Human Services, Office for Civil Rights.
WWDB featured CARIE’s SMP program on its Boomer Radio show yesterday. The first thirty minutes features a discussion about SMP and fraud. Diane Moskal, a SMP volunteer, and Hal Brody and Rebecca Nurick from CARIE’s staff were guests on the show.
CARIE Connection Archives
Are looking for a past issue of CARIE Connection? Click here to access past newsletters.
Public Policy Meeting Announcement
The next Dorothy S. Washburn Legislative Committee meeting will be held from 9:30 to 11:30 on Thursday, February 4, 2016 at CARIE’s office at Two Penn Center – Suite 1500. All are welcome. Hope you can join us. Stay tuned.
As always, please contact me if you have any questions.
267-546-3438 or 1-800-356-3606, ext. 3438